Press Release

Over Half of Sites in Global Youth Tobacco Survey Show No
Gender Difference in Cigarette Smoking

Helsinki, Finland – A new report released today at the World Conference
on Tobacco or Health shows that little difference exists between the genders
in cigarette smoking among youth. Results also show that girls and boys are
using non-cigarette tobacco products such as spit tobacco, bidis, and water
pipes at similar rates, and that these rates are often as high or higher
than youth cigarette smoking rates.

These findings suggest that projections of future tobacco-related deaths
worldwide might be underestimated because they are based on current patterns
of tobacco use among adults, where females are only about one-fourth as
likely as men to smoke cigarettes. In the new study of young people ages 13
to 15, no gender difference was found in over half of the sites surveyed for
cigarette smoking (61 of 120) and in over 70 percent of the sites surveyed
for other tobacco product use (82 of 117).

The lack of gender differences in cigarette smoking rates was found in
some of the sites in five of the six World Health Organization (WHO)
regions; in addition, no significant gender difference existed in rates of
other tobacco use at more than half of the sites in these same regions. Only
the Eastern Mediterranean Region had a majority of sites with boys
significantly more likely to smoke cigarettes and use other tobacco
products.

The new survey also found that young people’s use of cigarettes and other
tobacco products varied dramatically by site. For example, cigarette smoking
among boys ranged from 0.5 percent in Delhi and Goa, India, to 41.8 percent
in Bamako, Mali. Use of other tobacco products among girls ranged from 0.4
percent in Macao, China, to 62.2 percent in the Northern Mariana Islands.

Although adult-to-youth comparisons are difficult to make because of wide
variations in survey methods and timeframe, the following table shows that
differences in male-to-female smoking ratios were consistently smaller among
youth in the new study than among adults in previous studies.

Male-to-Female Smoking Ratios* by WHO Region

Adults

Youth

Africa

7.2 : 1

2.2 : 1

Americas

1.6 : 1

1.2 : 1

Eastern Mediterranean

8.8 : 1

4.3 : 1

Europe

1.8 : 1

1.2 : 1

Southeast Asia

11.0 : 1

4.2 : 1

Western Pacific

7.5 : 1

1.7 : 1

(*Ratio of male smoking prevalence to female smoking prevalence)

The report, published in the August issue of the American School Health
Association’s Journal of School Health, is from the Global Youth Tobacco
Survey (GYTS). The GYTS is the largest survey of its kind in the world,
surveying over one million adolescents from more than 150 countries. It is a
collaborative effort of the Centers for Disease Control and Prevention (CDC)
within the U.S. Department of Health and Human Services, the World Health
Organization (WHO) and its Regional Offices, the Canadian Public Health
Association, other international agencies, and individual countries.

Tobacco use is one of the chief preventable causes of death in the world.
The WHO currently attributes 4.9 million deaths per year to tobacco use, a
total expected to double in two to three decades. WHO and CDC developed the
GYTS to track tobacco use among young people across countries using a common
methodology and core questionnaire. The GYTS surveillance system is intended
to enhance the capacity of countries to design, implement, and evaluate
tobacco control and prevention programs.

“The data from this report have major implications for tobacco control,”
said Charles W. Warren, PhD, CDC’s lead scientist on the GYTS. “First,
programs specific to gender must be developed which emphasize the serious
health consequences of tobacco use, especially the risk of poor reproductive
health and health risks to infants exposed to tobacco toxins during
pregnancy. Second, the widespread use of other tobacco products in addition
to cigarettes in many countries means that tobacco control programs must be
broad in scope.”

“This finding could raise the projection of 10 million tobacco related
deaths per year, by the year 2030, which does not reflect these high rates
of tobacco use among girls,” said Vera da Costa e Silva, PhD, project
manager for the WHO’s Tobacco Free Initiative. “The GYTS will be one of the
primary data monitoring systems used by countries as they begin to develop,
implement, and evaluate their tobacco control programs to reduce these
rates. Surveillance systems like the GYTS will become vital components used
by countries to monitor and evaluate their strategies and programs
implemented to meet the goals and targets of the Framework Convention on
Tobacco Control (FCTC).”

The GYTS is a school-based survey of students from public and private
schools. The classrooms are chosen randomly within selected schools, and all
students in selected classes are eligible for participation. The
questionnaire is self-administered, anonymous, and confidential. Although
the survey has a core set of questions, participating countries may add
questions of special interest. The GYTS has been completed in 25 sites in
the African Region, 42 sites in the Americas, 14 sites in the Eastern
Mediterranean Region, eight sites in Europe, 22 sites in Southeast Asia, and
10 sites in the Western Pacific Region.

The WHO and CDC aim to expand the number of participating countries so
that they will have a standard tool to monitor components of their tobacco
control programs, to measure trends, and to evaluate the effectiveness of
intervention programs designed to reduce tobacco use among youth.

(Note to Reporters: GYTS is the source of the youth data in the Gender
Differential table. The source of the adult data is WHO’s Tobacco or Health:
A Global Status Report, 1997.)

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